Ear, Nose and Throat Disorders Forum - Mycoplasma Infections Testing Report!

I got this report from medscape.Com but I can not paste the link here cause it prompts for a loging password so I decided to paste the whole report. Please read!

From acp medicine

posted 07/26/2005

r. Doug hardy, md

best tests for diagnosing mycoplasma pneumonia:
clinical findings, general laboratory tests, and chest radiography are not useful for differentiating mycoplasma pneumonia from other types of community-acquired pneumonia.[1] measurement of cold agglutinin titers is no longer recommended for the diagnosis of mycoplasma pneumonia, because they are nonspecific and because assays specific for m. Pneumoniae are now available.

Laboratory diagnosis of an acute m. Pneumoniae infection can be established by the isolation of m. Pneumoniae from respiratory tract secretions (oropharyngeal, nasopharyngeal, or pulmonary) with polymerase chain reaction (pcr) or culture (which requires special media), or by the use of specific serologic tests, such as complement fixation, indirect immunofluorescence, and enzyme immunoassays (eias) for specific igm and igg antibodies in paired (acute and convalescent) serum samples (see table 1 ).[2] of these methods, eias are the most widely used and the most adaptable to the clinical laboratory setting.[3] serum samples for m. Pneumoniae serology taken only during the acute phase of illness may not be indicative of infection, because antibodies to m. Pneumoniae may not develop for 2 weeks or more; therefore, it is important to test both acute and convalescent serum samples for accurate diagnosis. Igm antibodies against m. Pneumoniae may not be produced during reinfection in older patients (i.E., persons older than 40 years with preexisting anti-m. Pneumoniae igg antibodies).[4] in addition, specific igm can persist for up to a year after acute m. Pneumoniae infection and thus may indicate recent infection rather than acute infection.[3]

antibiotics for wheezing:
in many patients, mycoplasma pneumoniae can be cultured from the respiratory tract for up to several months after clinical and radiologic resolution of acute pneumonia. There have been no controlled studies of such chronic infections using methods more sensitive than culture, such as pcr. M. Pneumoniae apparently can be a long-term respiratory tract pathogen associated with recurrent wheezing, and it may contribute to the severity of chronic asthma.[5]

in both animal and human studies, antimycoplasmal therapy significantly alleviated chronic respiratory disease caused by m. Pneumoniae.[6,7] a randomized, double-blind, placebo-controlled trial in patients with stable chronic asthma showed that 6 weeks of treatment with clarithromycin produced significant improvement on respiratory function testing in those patients who tested positive for m. Pneumoniae by pcr but not in those who tested negative; control subjects who received placebo also showed no improvement.[7] additional clinical studies are needed to strengthen this observation.

Mycoplasma in the cns:
neurologic disease is reportedly the most common nonpulmonary manifestation of m. Pneumoniae infection. A wide spectrum of neurologic manifestations has been reported. The most common ones are meningoencephalitis, encephalitis, polyradiculopathy (including guillain-barré syndrome), and aseptic meningitis. Preliminary evidence indicates that direct invasion of the central nervous system by m. Pneumoniae may be the pathogenic mechanism in encephalitis cases in which prodromal symptoms are of short duration (< 5 days), whereas immunologic phenomena may be responsible for cases with a more prolonged prodrome. The roles of antimicrobial therapy and immune-modulating therapy in the treatment of m. Pneumoniae neurologic disease are unknown.